Payer policies › CPT 4901449014 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 49014 Medicaid fee-for-service AZ: $385.28 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $294.26 (chp_plus, non-facility), effective Jul 1, 2026 FL: $269.12 (physician, non-facility), effective Jan 1, 2026 IL: $268.07 (practitioner), effective Apr 1, 2024 IN: $282.00 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $186.71 (default, Exempt Physician), effective Aug 1, 2024 KY: $292.95 (physician, facility), effective Jan 1, 2026 LA: $336.46 (professional), effective Jan 1, 2020 MA: $274.23 (physician_surgery), effective May 1, 2024 MS: $289.13 (comprehensive), effective Jul 1, 2026 ND: $349.96 (physician), effective Aug 1, 2026 NE: $151.16 (physician, non-facility), effective Jul 1, 2026 OH: $297.04 (physician), effective Jan 1, 2020 OK: $304.93 (physician, non-facility), effective Jul 1, 2026 TX: $290.78 (physician, Physician, facility), effective Sep 1, 2026 VA: $299.77 (medical, facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $197.60 (physician, facility), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026 From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.